Will the NHS fall off a cliff this winter?

The General Medical Council has warned a crunch is coming, and polls suggest the public is getting worried. John Appleby of the Nueld Trust reviews the evidence

Speed data

THE FINANCES:

England’s hospitals are rapidly plunging into the red

At the end of the expansionary New Labour days, austerity arrived and the rapid growth of NHS spending slowed to a crawl. But hospitals’ books did not immediately indicate any great distress. For a time, small surpluses suggested they had learned to do more with less. But in 2013/14 the surpluses vanished, and a small average deficit crept in. By last year, this had ballooned to £2.5bn, and the real figure—once we strip out Whitehall’s bailouts, which will have to be repaid—is more like £3.5bn, or about 5 per cent of hospitals’ budget. The deficit is not concentrated in a few institutions: the vast majority are now running overdrafts. They have limited flexibility and little obligation to close wards or A&E doors. So the crisis plays out through drift—with the NHS spending as if it could print its own money, running up a tab the Treasury will not tolerate foreve.

About Prospect Magazine

In Prospect’s December issue: Sam Tanenhaus argues that Donald Trump was born to be a campaigning demagogue, but will he be too bored to rule? Ed Miliband and Michael Gove debate whether parliament should have a binding vote on the terms of Brexit and Christian Wolmar examines the driverless car delusion.
Also in this issue: James Harkin examines the situation in Syria, focussing on Raqqa Ruth Dudley Edwards explores the battle in Ireland since the UK’s decision to leave the EU—will the border become a division? And Michael White looks at the life of Alan Johnson, the Labour MP and former postie.